Fabeliz Services Limited

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to the quality and safety of the service.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider shared their direction and culture with staff through team meetings, supervisions and through leading by example. They did this by working with staff to lead by example and completed observations of staff practice. This enabled people to feel engaged with and supported in a person centred way.

Staff understood the provider’s values and worked to ensure they were upheld when supporting people. One member of staff told us the values of the organisation were the same as hers: a “passion for people” where they “go above and beyond” for people.

Leaders had auditing processes which ensure staff worked in line with their values.

Leaders did not always understand the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge and experience to lead effectively, or they did not always do so with integrity and openness.

The service had a registered manager in post who was also the nominated individual. Concerns were raised by professionals that the registered manager did not always maintain appropriate professional boundaries, which affected the way people were supported. For example, the registered manager had obtained end-of-life medication without having completed the required training to administer it, raising concerns about their knowledge, experience, and ability to lead safely and effectively.

However, people and their relatives were complimentary about the leaders and felt they were supportive and inclusive.

Staff told us managers were open and approachable, and felt their voices were heard and listened to. One member of staff said the registered manager was “supportive and approachable”, another told us they listened to any concerns raised.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People and their families shared they would not have not concerns raising concerns with the provider. The provider sought feedback from people using questionnaires and through talking to people.

Staff were confident they would be listened to and that the provider would take appropriate action when needed.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff shared they felt the provider was inclusive in the way they provided support to them within the workplace. One member of staff shared they had been anxious about returning to work after a break from employment but that the registered manager had made their return very easy.

The provider did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The provider did not always act in a way that ensured peoples risks were minimised, nor did they always share appropriate information with partners and other professionals.

The providers governance and roles and responsibilities were clearly defined.

Audits completed by managers demonstrated oversight of the provision of services. They completed a range of audits. such as medicine audits and care log reviews. Staff received supervisions and appraisals that enabled them to learn and develop their skills. Leaders listened to feedback from people, their families and staff to ensure the service they were providing continued to adapt to people’s needs.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

During this assessment we found the registered manager had acted against medical advice. For example, the registered manger collected end-of-life medication and proposed to administer it despite lacking the necessary training or qualification. Furthermore, the registered manager delayed a scheduled ambulance transfer to hospital to enable a service user to access specific treatment by refusing paramedics entry to the service user's home. This led to the service user experiencing prolonged time without the appropriate medicines and a delay in accessing critical hospital care. This incident has been subject to safeguarding procedures, highlighting a breakdown in safe and effective leadership and governance.

We also found on several occasions, the Registered Manager involved service users' family members without the service users' explicit knowledge or agreement, even when the individuals had the capacity to provide consent. This demonstrated a lapse in professional boundaries and respect for autonomy, depriving people of their fundamental right to choice and control over the sharing of their personal information and relationships. These concerns have also been subject to safeguarding referrals.

The provider shared they had reflected on these incidents and recently introduced a new way of working, including how they contacted professionals and ensuring their role and responsibilities were clearly defined adhered to. They told us were now not trying to act as representatives of people they support, instead, they planned to ask for professional advocates to support people. They felt these actions would enable them to keep clear boundaries and to rebuild relationships with other professionals, however this way of working had not yet been embedded by the registered manager.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The provider had not always learnt from their engagement with other professionals about how to engaged with them. Further they had not followed the recommendations of their last inspection report by continuing to fail to ensure staff were recruited safely, demonstrating they were not ensuring improvements were being made within the service.

However, the provider’s model of care and support was aligned with person centred approaches. They supported people with respect and in an inclusive way. They sought feedback from people and their families and from staff to enable them to learn and develop safe support systems.